NHA CBCS EXAM 1 Questions and Answers with
Rationales 2026/2027 Update
1. What is the primary purpose of medical coding?
A. To diagnose patients
B. To translate documented healthcare services and diagnoses into
standardized codes
C. To determine a patient's treatment plan
D. To prescribe medications
Answer: B
Rationale: Medical coding converts documented diagnoses,
procedures, and services into standardized classification codes used for
billing, reporting, and healthcare data.
2. Which code set is primarily used to report diagnoses in U.S.
healthcare settings?
A. CPT
B. HCPCS Level II
C. ICD-10-CM
D. CDT
Answer: C
Rationale: ICD-10-CM is used to classify and report diagnoses and
health conditions in the United States.
3. CPT codes are primarily used to report:
A. Diagnoses
B. Physician and other professional services and procedures
C. Hospital room numbers
D. Patient demographics
,Answer: B
Rationale: CPT describes medical, surgical, and diagnostic services and
procedures performed by healthcare professionals.
4. HCPCS Level II codes are commonly used for:
A. Procedures exclusively described by CPT
B. Supplies, durable medical equipment, medications, and certain
services
C. Diagnoses only
D. Laboratory reference ranges
Answer: B
Rationale: HCPCS Level II expands coding for products and services not
fully represented by CPT.
5. What does ICD stand for?
A. International Classification of Diseases
B. Internal Clinical Diagnosis
C. International Clinical Documentation
D. Integrated Coding Database
Answer: A
Rationale: ICD means International Classification of Diseases.
6. What is the purpose of the ICD-10-CM Alphabetic Index?
A. To provide an initial location for finding diagnostic terms
B. To determine reimbursement automatically
C. To replace the Tabular List
D. To list CPT modifiers
Answer: A
Rationale: Coders use the Alphabetic Index to locate a diagnosis term
and then verify the appropriate code in the Tabular List.
,7. Why must a coder verify a code in the Tabular List after locating it in
the Index?
A. The Index always contains every coding instruction
B. The Tabular List provides additional instructions, specificity, and
exclusions
C. The Tabular List contains only CPT codes
D. Verification is optional
Answer: B
Rationale: Coding requires review of the Tabular List for notes,
inclusion terms, exclusions, and other instructions.
8. What does an Excludes1 note generally indicate?
A. The two conditions should generally not be coded together
B. The second condition must always be coded
C. The code is optional
D. The diagnosis is unspecified
Answer: A
Rationale: An Excludes1 note indicates that the excluded condition is
not coded with the code where the note appears under normal
circumstances.
9. What does an Excludes2 note generally mean?
A. The excluded condition is never separately reportable
B. The excluded condition is not part of the code but may be coded
separately when appropriate
C. The code cannot be used
D. The diagnosis is prohibited
Answer: B
Rationale: Excludes2 indicates that the excluded condition is separate
and may be reported when clinically appropriate.
, 10. What is a combination code?
A. A code that represents two or more diagnoses or a diagnosis with a
complication/manifestation
B. A code that can never be billed
C. A code used only for procedures
D. A code with no diagnosis information
Answer: A
Rationale: Combination codes capture multiple related elements within
one code when classification rules permit.
11. A coder should assign a diagnosis code based primarily on:
A. What the coder thinks the patient has
B. Provider documentation and applicable coding guidelines
C. The patient's insurance company preference
D. The patient's medication list alone
Answer: B
Rationale: Coders report conditions supported by provider
documentation rather than independently diagnosing patients.
12. If documentation is insufficient to assign the most specific code, the
coder should:
A. Guess the missing information
B. Query the provider when appropriate
C. Select the most expensive code
D. Ignore the diagnosis
Answer: B
Rationale: A compliant provider query can clarify clinically relevant
information needed for accurate coding.
13. A coder discovers documentation that conflicts with itself. What is
the best action?
Rationales 2026/2027 Update
1. What is the primary purpose of medical coding?
A. To diagnose patients
B. To translate documented healthcare services and diagnoses into
standardized codes
C. To determine a patient's treatment plan
D. To prescribe medications
Answer: B
Rationale: Medical coding converts documented diagnoses,
procedures, and services into standardized classification codes used for
billing, reporting, and healthcare data.
2. Which code set is primarily used to report diagnoses in U.S.
healthcare settings?
A. CPT
B. HCPCS Level II
C. ICD-10-CM
D. CDT
Answer: C
Rationale: ICD-10-CM is used to classify and report diagnoses and
health conditions in the United States.
3. CPT codes are primarily used to report:
A. Diagnoses
B. Physician and other professional services and procedures
C. Hospital room numbers
D. Patient demographics
,Answer: B
Rationale: CPT describes medical, surgical, and diagnostic services and
procedures performed by healthcare professionals.
4. HCPCS Level II codes are commonly used for:
A. Procedures exclusively described by CPT
B. Supplies, durable medical equipment, medications, and certain
services
C. Diagnoses only
D. Laboratory reference ranges
Answer: B
Rationale: HCPCS Level II expands coding for products and services not
fully represented by CPT.
5. What does ICD stand for?
A. International Classification of Diseases
B. Internal Clinical Diagnosis
C. International Clinical Documentation
D. Integrated Coding Database
Answer: A
Rationale: ICD means International Classification of Diseases.
6. What is the purpose of the ICD-10-CM Alphabetic Index?
A. To provide an initial location for finding diagnostic terms
B. To determine reimbursement automatically
C. To replace the Tabular List
D. To list CPT modifiers
Answer: A
Rationale: Coders use the Alphabetic Index to locate a diagnosis term
and then verify the appropriate code in the Tabular List.
,7. Why must a coder verify a code in the Tabular List after locating it in
the Index?
A. The Index always contains every coding instruction
B. The Tabular List provides additional instructions, specificity, and
exclusions
C. The Tabular List contains only CPT codes
D. Verification is optional
Answer: B
Rationale: Coding requires review of the Tabular List for notes,
inclusion terms, exclusions, and other instructions.
8. What does an Excludes1 note generally indicate?
A. The two conditions should generally not be coded together
B. The second condition must always be coded
C. The code is optional
D. The diagnosis is unspecified
Answer: A
Rationale: An Excludes1 note indicates that the excluded condition is
not coded with the code where the note appears under normal
circumstances.
9. What does an Excludes2 note generally mean?
A. The excluded condition is never separately reportable
B. The excluded condition is not part of the code but may be coded
separately when appropriate
C. The code cannot be used
D. The diagnosis is prohibited
Answer: B
Rationale: Excludes2 indicates that the excluded condition is separate
and may be reported when clinically appropriate.
, 10. What is a combination code?
A. A code that represents two or more diagnoses or a diagnosis with a
complication/manifestation
B. A code that can never be billed
C. A code used only for procedures
D. A code with no diagnosis information
Answer: A
Rationale: Combination codes capture multiple related elements within
one code when classification rules permit.
11. A coder should assign a diagnosis code based primarily on:
A. What the coder thinks the patient has
B. Provider documentation and applicable coding guidelines
C. The patient's insurance company preference
D. The patient's medication list alone
Answer: B
Rationale: Coders report conditions supported by provider
documentation rather than independently diagnosing patients.
12. If documentation is insufficient to assign the most specific code, the
coder should:
A. Guess the missing information
B. Query the provider when appropriate
C. Select the most expensive code
D. Ignore the diagnosis
Answer: B
Rationale: A compliant provider query can clarify clinically relevant
information needed for accurate coding.
13. A coder discovers documentation that conflicts with itself. What is
the best action?
